Memorandum CITY OF DALLAS OATE April 3, 2017 TO SUBJECT Honorable Members of the Committee: Adam Medrano (Chair), B. Adam McGough (Vice Chair), Sandy Greyson, Tiffinni A. Young, Jennifer S. Gates, Philip T. Kingston RIGHT Care Pilot Program On Monday, April 10, 2017, you will be briefed on the Dallas Fire-Rescue Department s RIGHT Care Pilot Program by Acting Assistant Chief George Gamez. The briefing materials are attached for your review. Please contact me if you have any questions or need additional information. Eric D. Campbell Assistant City Manager [Attachmentj cc: Honorable Mayor and Members of the City Council TC Broadnax, City Manager Lany Casto, City Attorney Craig D. Kinton, City Auditor Rosa A. Rios, City Secretary Daniel F. SoIls, Administrative Judge Kimberly Bizor Tolbert, Chief of Staff to the City Manager Theresa O Donnell, Interim Chief of Economic Development & Nrkghborhood Services Majed A AI-Ghafry. Assistant City Manager Mark McDanil, Assistant City Manager Jill A, Jordan, P.E., Assistant City Manager Joey Zapata, Assistant City Manager M. Elizabeth Reich, Chief Financial Officer Alan E. Sims, Interim Chief of Community Services Directors and Assistant Directors Dailas, The City That Works: Diverse, Vibrant and Progressiv&
RIGHT Care Pilot Program Committee April 10, 2017 George Gamez, Acting Assistant Chief Dallas Fire-Rescue Department City of Dallas S. Marshal Isaacs, MD Medical Director Dallas Fire-Rescue Department
Overview To understand why this Pilot Program has been developed To describe the Rapid Integrated Group Healthcare Team (RIGHT) Care Pilot Program components of Dallas County Smart Justice implementation project To delineate the goals of the program 2
Overview, Cont. To thank the W. W. Caruth, Jr. Foundation, Communities Foundation of Texas and the Meadows Mental Health Policy Institute (MMHPI) for grant funding To seek input and approval from the Public Safety Committee to move forward with development of the Pilot Program 3
Behavioral Health Patients Parkland DPD EMS/Fire Operations Behavioral health Jail/Courts Green Oaks Other Dallas Emergency Departments 4
Why do we need this Program Contact with local law enforcement and DFR EMS 15,593 behavioral health calls a year in Dallas Since 2012, an increase of 18% overall and 59% needing an ambulance Jail 21% receive psychotropic medication 25% have past/current mental health system contact 58% rearrested 5
Why do we need this Program, Cont. Super-utilizers More than 6,000 super-utilizers in Dallas, with 4,000 living in poverty Less than 1 in 7 are in care 75% use jail repeatedly Community-based and inpatient behavioral health care services Super-Utilizers need ongoing intensive care, housing, and supervision 6
The Challenge The challenge of trying to connect persons living with mental illness to behavioral health care: Time spent responding, de-escalating, and then transporting these patients Revolving Door of treatment facilities and ERs Varying policies and procedures between agencies Concern for liability if we do not do the right thing Need for more training and improved information sharing 7
Key Partners Dallas County Behavioral Health Leadership Team Dallas Police Department (DPD) Dallas Fire-Rescue Department (DFD) Dallas-Fort Worth Hospital Council North Texas Behavioral Health Authority (NTBHA) Dallas City, County, and Region Community Behavioral Health Providers Adapt Community Solutions Centro de Mi Salud Child and Family Guidance Center Homeward Bound Integrated Psychotherapeutic Services Metrocare Services Southern Area Behavioral Health Transicare, Inc. Baylor Scott & White HCA System/Green Oaks Hospital Methodist Health System Parkland Health & Hospital System Texas Health Resources Universal Health Services The University of Texas Southwestern Medical School Hospital Systems Key Data Partners Loopback Analytics PCCI / Pieces Harris Logic Xenatix 8
RIGHT Care Pilot Program Components 911 center behavioral health triage professionals RIGHT Care Response Team: DFR Paramedic, DPD Officer, and Behavioral Health Professionals Response Vehicle Medical Direction (policies/procedures/consultation) 9
South Central District 10 DRAFT
Proposed Program Outcomes Improved care for Dallas Citizens and Safety for our responders Free up law enforcement and DFR EMS Focus more on public safety rather than mental health service delivery Reduce Dallas County s high recidivism rates For people with mental illness released from jail Permanently shift $40 million a year in healthcare costs From emergency rooms and the jail to evidence-based care 11
Proposed Program Outcomes, Cont. Improved care for Dallas Citizens and Safety for our responders Multidisciplinary Response Teams Paramedic, mental health professional, law enforcement Real-Time IT Surveillance Systems Linking law enforcement, jail, emergency rooms to divert Expanding crisis drop-off options 12
Proposed Action Seek Council approval to accept the grant Develop standard operating procedures Partner with behavioral health professionals Recruit and select appropriate personnel Provide training for DPD and DFR 13
Proposed Action, Cont. Obtain vehicle and equipment Begin Proof of Concept phase Evaluate and modify as appropriate 14
Grant Funding Personnel Equipment Response Vehicle Office space Data Analysis 15
Grant Funding, Cont. Thank you to the W.W. Caruth, Jr. Foundation and MMHPI for awarding $2.2 million dollars over 3 years to fund this program. 16
Staff Recommendation/Next Steps Staff recommends the Committee forward the following to City Council for consideration and approval: Approval to accept the grant and execute Approval to move forward with development of the RIGHT Care Pilot Program Council Action Upcoming Agenda Item - Wednesday, April 26, 2017 17
RIGHT Care Pilot Program Committee April 10, 2017 George Gamez, Acting Assistant Chief Dallas Fire-Rescue Department City of Dallas S. Marshal Isaacs, MD Medical Director Dallas Fire-Rescue Department